scholarly journals Efficacy of “stay-at-home” policy and transmission of COVID-19 in Toronto, Canada: a mathematical modeling study

2020 ◽  
Author(s):  
Pei Yuan ◽  
Juan Li ◽  
Elena Aruffo ◽  
Qi Li ◽  
Tingting Zheng ◽  
...  
Keyword(s):  
Public Health ◽  
Epidemic Model ◽  
Reproduction Number ◽  
Compliance Rate ◽  
Household Structure ◽  
Added Value ◽  
High Rate ◽  
Subsequent Increase ◽  
Symptomatic Diagnosis ◽  
At Home

SummaryBackgroundIn many parts of the world, restrictive non-pharmaceutical interventions (NPI) that aim to reduce contact rates, including stay-at-home orders, limitations on gatherings, and closure of public places, are being lifted, with the possibility that the epidemic resurges if alternative measures are not strong enough. Here we aim to capture the combination of use of NPI’s and reopening measures which will prevent an infection rebound.MethodsWe employ an SEAIR model with household structure able to capture the stay-at-home policy (SAHP). To reflect the changes in the SAHP over the course of the epidemic, we vary the SAHP compliance rate, assuming that the time to compliance of all the people requested to stay-at-home follows a Gamma distribution. Using confirmed case data for the City of Toronto, we evaluate basic and instantaneous reproduction numbers and simulate how the average household size, the stay-at-home rate, the efficiency and duration of SAHP implementation, affect the outbreak trajectory.FindingsThe estimated basic reproduction number R_0 was 2.36 (95% CI: 2.28, 2.45) in Toronto. After the implementation of the SAHP, the contact rate outside the household fell by 39%. When people properly respect the SAHP, the outbreak can be quickly controlled, but extending its duration beyond two months (65 days) had little effect. Our findings also suggest that to avoid a large rebound of the epidemic, the average number of contacts per person per day should be kept below nine. This study suggests that fully reopening schools, offices, and other activities, is possible if the use of other NPIs is strictly adhered to.InterpretationOur model confirmed that the SAHP implemented in Toronto had a great impact in controlling the spread of COVID-19. Given the lifting of restrictive NPIs, we estimated the thresholds values of maximum number of contacts, probability of transmission and testing needed to ensure that the reopening will be safe, i.e. maintaining an Rt < 1.Research in contextEvidence before this studyA survey on published articles was made through PubMed and Google Scholar searches. The search was conducted from March 1 to August 13, 2020 and all papers published until the end of this research were considered. The following terms were used to screen articles on mathematical models: “household structure”, “epidemic model”, “SARS-CoV-2”, “COVID-19”, “household SIR epidemic”, “household SIS epidemic”, “household SEIR epidemic”, “quarantine, isolation model”, “quarantine model dynamics”, “structured model isolation”. Any article showing, in the title, application of epidemic models in a specific country/region or infectious diseases rather than SARS-CoV-2 were excluded. Articles in English were considered.Added value of this studyWe develop an epidemic model with household structure to study the effects of SAHP on the infection within households and transmission of COVID-19 in Toronto. The complex model provides interesting insights into the effectiveness of SAHP, if the average number of individuals in a household changes. We found that the SAHP might not be adequate if the size of households is relatively large. We also introduce a new quantity called symptomatic diagnosis’ completion ratio (d_c). This indicator is defined as the ratio of cumulative reported cases and the cumulative cases by episode date at time t, and it is used in the model to inform the implementation of SAHP.If cases are diagnosed at the time of symptom onset, isolation will be enforced immediately. A delay in detecting cases will lead to a delay in isolation, with subsequent increase in the transmission of the infection. Comparing different scenarios (before and after reopening phases), we were able to identify thresholds of these factors which mainly affect the spread of the infection: the number of daily tests, average number of contacts per individual, and probability of transmission of the virus. Our results show that if any of the three above mentioned factors is reduced, then the other two need to be adjusted to keep a reproduction number below 1. Lifting restrictive closures will require the average number of contacts a person has each day to be less than pre-COVID-19, and a high rate of case detection and tracing of contacts. The thresholds found will inform public health decisions on reopening.Implications of all the available evidenceOur findings provide important information for policymakers when planning the full reopening phase. Our results confirm that prompt implementation of SAHP was crucial in reducing the spread of COVID-19. Also, based on our analyses, we propose public health alternatives to consider in view of a full reopening. For example, for different post-reopening scenarios, the average number of contacts per person needs to be reduced if the symptomatic diagnosis’ completion ratio is low and the probability of transmission increases. Namely, if fewer tests are completed and the usage of NPI’s decreases, then the epidemic can be controlled only if individuals can maintain contact with a maximum average number of 4-5 people per person per day. Different recommendations can be provided by relaxing/strengthening one of the above-mentioned factors.

Crucial role of physiotherapy in treating COVID-19 patients

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 967-971
Author(s):  
Poonam Thakre ◽  
Waqar M. Naqvi ◽  
Trupti Deshmukh ◽  
Nikhil Ingole ◽  
Sourabh Deshmukh
Keyword(s):  
Public Health ◽  
Distress Syndrome ◽  
Public Health Problem ◽  
Public Health Emergency ◽  
High Rate ◽  
Major Public Health Problem ◽  
Front Line ◽  
The Many ◽  
Sixth International

The emergence in China of 2019 of severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) previously provisionally names 2019-nCoV disease (COVID19) caused major global outbreak and is a major public health problem. On 30 January 2020, the WHO declared COVID19 to be the sixth international public health emergency. This present pandemic has engrossed the globe with a high rate of mortality. As a front line practitioner, physiotherapists are expected to be getting in direct contact with patients infected with the virus. That’s why it is necessary for understanding the many aspects of their role in the identification, contains, reduces and treats the symptoms of this disease. The main presentation is the involvement of respiratory system with symptoms like fever, cough, sore throat, sneezing and characteristics of pneumonia leads to ARDS(Acute respiratory distress syndrome) also land up in multiorgan dysfunction syndrome. This text describes and suggests physiotherapy management of acute COVID-19 patients. It also includes recommendations and guidelines for physiotherapy planning and management. It also covers the guidelines regarding personal care and equipment used for treatment which can be used in the treatment of acute adult patients with suspected or confirmed COVID-19.

Disposal Practices of Unused Medications Among Patients in Public Health Centers of Dessie Town, Northeast Ethiopia: A Cross-sectional Study

2020 ◽  
Vol 15 (2) ◽  
pp. 105-110
Author(s):  
Haile Kassahun ◽  
Dugessa Tesfaye
Keyword(s):  
Public Health ◽  
Health Care Professionals ◽  
Cross Sectional Study ◽  
Health Centers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Global Challenge ◽  
Northeast Ethiopia ◽  
Unused Medications ◽  
At Home

Background: Disposal of pharmaceutical waste among patients is a global challenge especially in developing countries like Ethiopia. Improper medication disposal can lead to health problems and environmental contaminations. Therefore, the present study aimed to assess disposal practices of unused medications among patients in public health centers of Dessie town, Northeast Ethiopia. Methods: A descriptive cross-sectional study was conducted among 263 patients in four public health centers of Dessie town, Ethiopia from March to June, 2019. Face-to-face interviews using structured questionnaires were used to collect data from each study subject. Results: The majority of the respondents, 224 (85.17%) had unused medications at their home during the study period. The most commonly reported disposal method in the present study was flushing down into a toilet 66 (25.09%). None of the respondents practiced returning unused medications to Pharmacy. Moreover, 85 (32.31%) of the respondents reported never disposing their medications and believed that it is acceptable to store medications at home for future use. Conclusion: In the present study, there was a high practice of keeping medications at home and most of the disposal practices were not recommended methods. In addition, most of the respondents did not get advice from pharmacists and other health care professionals on how to dispose off unused medications. Hence, there is a need for proper education and guidance of patients regarding disposal practices of unused medications.

Stability Analysis of an SEIR Epidemic Model with Stochastic Perturbation and Numerical Simulation

2013 ◽  
Vol 14 (2) ◽  
Author(s):  
Xiaoming Fan ◽  
Zhigang Wang
Keyword(s):  
Numerical Simulation ◽  
Asymptotic Behavior ◽  
Epidemic Model ◽  
Reproduction Number ◽  
Stochastic Perturbation ◽  
Random Fluctuation ◽  
Deterministic System ◽  
Stochastic Version ◽  
Special Case ◽  
The Basic Reproduction Number

AbstractAn SEIR epidemic model with constant immigration and random fluctuation around the endemic equilibrium is considered. As a special case, a deterministic system discussed by Li et al. will be incorporated into the stochastic version given by us. We carry out a detailed analysis on the asymptotic behavior of the stochastic model, also regarding of the basic reproduction number ℛ

scholarly journals Global dynamics of a novel deterministic and stochastic SIR epidemic model with vertical transmission and media coverage

2020 ◽  
Vol 2020 (1) ◽  
Author(s):  
Xiaodong Wang ◽  
Chunxia Wang ◽  
Kai Wang
Keyword(s):  
Vertical Transmission ◽  
Epidemic Model ◽  
Media Coverage ◽  
Existence And Uniqueness ◽  
Deterministic Model ◽  
Reproduction Number ◽  
Global Dynamics ◽  
Sir Epidemic Model ◽  
Sir Epidemic ◽  
Stochastic Sir

AbstractIn this paper, we study a novel deterministic and stochastic SIR epidemic model with vertical transmission and media coverage. For the deterministic model, we give the basic reproduction number $R_{0}$ R 0 which determines the extinction or prevalence of the disease. In addition, for the stochastic model, we prove existence and uniqueness of the positive solution, and extinction and persistence in mean. Furthermore, we give numerical simulations to verify our results.

scholarly journals Umbilical cord care through community-based distribution of chlorhexidine in rural Sindh, Pakistan

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Shah ◽  
Q Jamali ◽  
F Aisha
Keyword(s):  
Rural Communities ◽  
Data Collection ◽  
Umbilical Cord ◽  
Rural Areas ◽  
Health Workers ◽  
High Rate ◽  
Cord Care ◽  
Community Based ◽  
Sindh Province ◽  
At Home

Abstract Background Unsafe practices such as cutting umbilical cord with unsterilized instruments and application of harmful substances, are in practice in many rural areas of Pakistan, and associated with high risk of neonatal sepsis and mortality. Methods We conducted an implementation research in 2015 in Tharparkar district, in Sindh province of Pakistan to understand the feasibility and acceptability of community-based distribution of chlorhexidine (CHX) in rural Pakistan. For this cohort group-only study, 225 lady health workers (LHWs) enrolled 495 pregnant women. Enrolled women received 4% CHX gel and user’s instructions for newborn cord care. The LHWs also counseled women on the benefits and correct use of CHX. Study enumerators collected data from CHX receiving women 3 times: at around 2 weeks before delivery, within 24 hours after delivery, and on the 8th day after delivery. We implemented this study jointly in collaboration with Ministry of Health in Sindh province, Pakistan. Results Among enrolled participants, 399 women (81%) received only the first visit, 295 women (60%) received first two visits and 261 women (53%) received all three visits by enumerators. Among 399 women, who received CHX gel, counseling on its use and were respondent to the first round data collection, 78% remembered that the CHX gel to be applied to cord stump and surrounding areas immediately after birth; but less than a third (29%) forgot the need to keep the cord clean and dry. Among 295 respondents in the first two rounds of data collection, who delivered at home, 97% applied CHX to cord stump on the first day. Conclusions Community-based CHX distribution by LHWs, along with counseling to recipient women, resulted in a high rate of cord care with CHX among newborn delivered at home. Results from this study may help program implementers to consider expanding this intervention for improving newborn cord care on the first day of life in Pakistan. Key messages Community-based distribution of chlorhexidine for newborn cord care appears as highly acceptable and feasible in rural communities in Pakistan. Relevant program policy supporting community-based CHX distribution along with counseling by LHW may help expanding coverage of newborn cord care in rural communities in Pakistan.

scholarly journals A fractional order mathematical model for COVID-19 dynamics with quarantine, isolation, and environmental viral load

2021 ◽  
Vol 2021 (1) ◽  
Author(s):  
Mohammed A. Aba Oud ◽  
Aatif Ali ◽  
Hussam Alrabaiah ◽  
Saif Ullah ◽  
Muhammad Altaf Khan ◽  
...  
Keyword(s):  
Epidemic Model ◽  
Reproduction Number ◽  
Model Parameters ◽  
Disease Dynamics ◽  
Threshold Parameter ◽  
Fractional Model ◽  
Infected People ◽  
Fractional Models ◽  
Disease Epidemics ◽  
The Impact

AbstractCOVID-19 or coronavirus is a newly emerged infectious disease that started in Wuhan, China, in December 2019 and spread worldwide very quickly. Although the recovery rate is greater than the death rate, the COVID-19 infection is becoming very harmful for the human community and causing financial loses to their economy. No proper vaccine for this infection has been introduced in the market in order to treat the infected people. Various approaches have been implemented recently to study the dynamics of this novel infection. Mathematical models are one of the effective tools in this regard to understand the transmission patterns of COVID-19. In the present paper, we formulate a fractional epidemic model in the Caputo sense with the consideration of quarantine, isolation, and environmental impacts to examine the dynamics of the COVID-19 outbreak. The fractional models are quite useful for understanding better the disease epidemics as well as capture the memory and nonlocality effects. First, we construct the model in ordinary differential equations and further consider the Caputo operator to formulate its fractional derivative. We present some of the necessary mathematical analysis for the fractional model. Furthermore, the model is fitted to the reported cases in Pakistan, one of the epicenters of COVID-19 in Asia. The estimated value of the important threshold parameter of the model, known as the basic reproduction number, is evaluated theoretically and numerically. Based on the real fitted parameters, we obtained $\mathcal{R}_{0} \approx 1.50$ R 0 ≈ 1.50 . Finally, an efficient numerical scheme of Adams–Moulton type is used in order to simulate the fractional model. The impact of some of the key model parameters on the disease dynamics and its elimination are shown graphically for various values of noninteger order of the Caputo derivative. We conclude that the use of fractional epidemic model provides a better understanding and biologically more insights about the disease dynamics.

scholarly journals Team-Based Learning: Successful Experience in a Public Health Graduate Program

2017 ◽  
Vol 41 (3) ◽  
pp. 397-401
Author(s):  
Geraldo Bezerra da Silva Junior ◽  
Maria Angelina Silva Medeiros ◽  
Juliana Gomes Ramalho de Oliveira ◽  
Ana Maria Fontenele Catrib ◽  
Maria Helena de Agrela Gonçalves Jardim
Keyword(s):  
Public Health ◽  
Traditional Method ◽  
Quantitative Research ◽  
Graduate Program ◽  
Theory And Practice ◽  
Average Score ◽  
Master Program ◽  
The Public ◽  
Team Based Learning ◽  
At Home

ABSTRACT Background: In the review of curriculum matrices, the elaboration of learning strategies that combine theory and practice is extremely important, allowing the building of new concepts and learning methods by the students. Team-based learning (TBL) is growing in academic centers and refers to the pedagogic strategy grounded in constructivism. The aim of this research was to describe the application of TBL in a Public Health graduate program. Methods: TBL was applied in a class with 22 students in the discipline “Quantitative Research in Health” of the Public Health graduate program (Master degree) at the University of Fortaleza, Brazil, in 2016. The discipline was structured in 8 lessons, approaching the thematic of quantitative research. Before each class the students were required to study the contents at home, a test was done for each subject in the beginning of each class (individually and then in teams of 5 or 6 students) and then a brief review was performed by the professor, where the students could ask questions and solve any doubt. At the end of the semester an evaluation questionnaire was applied with objective questions and a qualitative survey. Results: The application of TBL was done in a class with 22 students of the Public health Master Program, aged 22 to 36 years, and 83.3% were female. The method was well received by the students. All the evaluations and discussions went on without any problem. There were some complaints about the requirement to study at home prior to the classes. Students’ evaluation of the discipline and the TBL method was satisfactory with answers’ average score of 4.7 (scale 0-5). The lowestscore was achieved by the question number 11 (4.3) about the students motivation for their study at home. The comparison with the evaluation of the previous semester (where a traditional method was applied) evidenced higher scores for the TBL method. Conclusions: The application of TBL was satisfactory and the main difficulty presented by students was the requirement for previous study at home. TBL was better evaluated than the traditional method.

scholarly journals Spatial dynamics of a diffusive SIRI model with distinct dispersal rates and heterogeneous environment

2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Lian Duan ◽  
Lihong Huang ◽  
Chuangxia Huang
Keyword(s):  
Steady State ◽  
Basic Reproduction Number ◽  
Epidemic Model ◽  
Reproduction Number ◽  
Spatial Dynamics ◽  
Heterogeneous Environment ◽  
Threshold Parameter ◽  
Dispersal Rate ◽  
Siri Model ◽  
The Basic Reproduction Number

<p style='text-indent:20px;'>In this paper, we are concerned with the dynamics of a diffusive SIRI epidemic model with heterogeneous parameters and distinct dispersal rates for the susceptible and infected individuals. We first establish the basic properties of solutions to the model, and then identify the basic reproduction number <inline-formula><tex-math id="M1">\begin{document}$ \mathscr{R}_{0} $\end{document}</tex-math></inline-formula> which serves as a threshold parameter that predicts whether epidemics will persist or become globally extinct. Moreover, we study the asymptotic profiles of the positive steady state as the dispersal rate of the susceptible or infected individuals approaches zero. Our analytical results reveal that the epidemics can be extinct by limiting the movement of the susceptible individuals, and the infected individuals concentrate on certain points in some circumstances when limiting their mobility.</p>

scholarly journals A window of opportunity for intensifying testing and tracing efforts to prevent new COVID-19 outbreaks due to more transmissible variants

2021 ◽  
Vol 47 (7/8) ◽  
pp. 329-338
Author(s):  
Jianhong Wu ◽  
Francesca Scarabel ◽  
Zachary McCarthy ◽  
Yanyu Xiao ◽  
Nicholas H Ogden
Keyword(s):  
Public Health ◽  
Reproduction Number ◽  
Health Interventions ◽  
Contact Tracing ◽  
Window Of Opportunity ◽  
New Wave ◽  
Public Health Interventions ◽  
Contact Rates ◽  
Large Outbreak ◽  
Restrictive Measures

Background: When public health interventions are being loosened after several days of decline in the number of coronavirus disease 2019 (COVID-19) cases, it is of critical importance to identify potential strategies to ease restrictions while mitigating a new wave of more transmissible variants of concern (VOCs). We estimated the necessary enhancements to public health interventions for a partial reopening of the economy while avoiding the worst consequences of a new outbreak, associated with more transmissible VOCs. Methods: We used a transmission dynamics model to quantify conditions that combined public health interventions must meet to reopen the economy without a large outbreak. These conditions are those that maintain the control reproduction number below unity, while accounting for an increase in transmissibility due to VOC. Results: We identified combinations of the proportion of individuals exposed to the virus who are traced and quarantined before becoming infectious, the proportion of symptomatic individuals confirmed and isolated, and individual daily contact rates needed to ensure the control reproduction number remains below unity. Conclusion: Our analysis indicates that the success of restrictive measures including lockdown and stay-at-home orders, as reflected by a reduction in number of cases, provides a narrow window of opportunity to intensify case detection and contact tracing efforts to prevent a new wave associated with circulation of more transmissible VOCs.

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